A conference committee of Ohio House and Senate members will focus on the state budget this week. And while the expansion of Medicaid is not expected to emerge from that committee in any form, a change in one line of the budget could at least open the way for two other Medicaid bills.

WKSU’s M.L. Schultze spoke with Capri Cafaro, the Northeast Ohio senator who is sponsoring one of those bills.

Gov. John Kasich included in the state budget plans to expand Medicaid to some 300,000 working-poor Ohioans. He’s arguing that the change makes moral and financial sense – and would be virtually all on the federal government’s nickel.

But the expansion appears nowhere in the Senate or House versions of the budget. In fact, both versions expressly forbid such an expansion.

Sen. Capri Cafaro – a Democrat and expansion proponent -- says she and other Democrats and Republicans and have decided to focus instead on new bills that begin with controlling Medicaid’s costs.

Three steps“Not by kicking people off of Medicaid, but rather by tying per member/per month spending growth to the medical rate of inflation. And then, in order to support that fiscal goal, there will be underlying policy changes that will support that. So the objective, obviously, is to serve more people and do it in a more efficient way, but also improve health outcomes, which is critically important.

State lawmakers expect to get figures from Medicaid economists this week estimating cost controls through programs such as accountable-care organizations and patient-centered home medical care.

Job training as health careBut Cafaro says her bipartisan bill also pushes job training as a way to control Medicaid costs and says the federal Affordable Care Act – to which many House and Senate Republicans object – would enable that.

“Particularly for what I’m referring to as the Medicaid transition population, those that would be up to 138 percent of poverty, … currently falling through the current eligibility structure. These folks are working; they are the working poor. … It’s good policy at any time that we can empower individuals to better themselves. Before the Affordable Care Act… , there wasn’t really a bridge out of Medicaid.

“And so now, if we can provide them with coverage, we can at we can at least support their efforts and help them get on the exchange if and when they are past 138 percent, and then they can get premium support and subsidies so they can afford that on the open market.

Cafaro acknowledges, though, that none of that counters the language of the budget passed by GOP lawmakers that prohibits accepting federal money for the Medicaid expansion.

And she acknowledges that the prohibition has to go if any Medicaid expansion is to happen and says she hopes the House and Senate conference committee will strike it.

But proponents do have one other hope. Gov. Kasich has a line-item veto, and could use it to cross-out the prohibition if the lawmakers don’t. And Cafaro says, based on Kasich public statements supporting the expansion, she thinks that could well happen.